高血壓病人的他人效能、自我效能與服藥遵從性之關係：關係品質與病人參與之中介效果

Other-efficacy, Self-efficacy and Medication adherence: The Mediating Effects of Relationship Quality and Patient Participation in Hypertension patients

陳靜誼(Ching-I Chen) ； 郭貴玲(Kuei-Ling Kuo) ； 洪俊聲(Chon-Seng Hong) ； 馮琡珺(Chu-Chun Feng)

《醫務管理期刊》 23卷4期 (2022/12) Pp. 309-328

https://doi.org/10.6174/JHM.202212_23(4).309

摘要

目的：本研究為瞭解高血壓患者的服藥遵從性不甚理想之影響因素，藉由三元效能信念模式探討病人的自我效能、他人效能對關係品質的影響，亦釐清關係品質、病人參與及服藥遵從性之關係；進一步檢視關係品質與病人參與的中介效果。方法：本研究採橫斷式研究設計，以南部某醫學中心臟血管科高血壓病人與醫師為研究對象，共計220份有效配對問卷；採用PLS-SEM瞭解服藥遵從性的預測因子及檢測中介效果。結果：病人對醫師能力所產生的他人效能正向影響其知覺醫病之關係品質，關係品質亦能提升病人向醫師分享疾病相關資訊與討論病情等參與行為，進而影響服藥遵從性。關係品質在他人效能與病人參與具有部分中介效果；病人參與亦在關係品質與服藥遵從性具有部分中介效果。結論：醫師欲提升服藥遵從性，應強化病人知覺醫師能力的信心程度，以增進關係品質，提升病人參與程度。

關鍵字

他人效能 ； 自我效能 ； 關係品質 ； 病患參與 ； 服藥遵從性

並列摘要

Objectives: The purpose of this study was to investigate the factors of suboptimal medication adherence in patients with hypertension. This study employs the concept of self-efficacy and other-efficacy in a tripartite efficacy model to examine the factors for relationship quality, analyze the association between relationship quality, patient participation and medication adherence, and validate the mediating effect of relationship quality and patient participation. Methods: This cross-sectional study collected 220 valid questionnaires from outpatients with hypertension of the cardiovascular department at a medical center in southern Taiwan. The data was analyzed using the partial least squares method. Results: Empirical results confirmed that other-efficacy affect relationship quality, relationship quality affects patient participation, and patient participation affects medication adherence. In addition, relationship quality showed partial mediating effects between other-efficacy and patient participation, whereas patient participation showed partial mediating effects between relationship quality and medication adherence. Conclusions: We recommend that physicians draft medication adherence strategies that increase other-efficacy in medical professionals. These measures may improve relationship quality between physicians and patients, and participation behavior in patients.

並列關鍵字

Other-efficacy ； Self-efficacy ； Relationship quality ； Patient participation ； Medication adherence

參考文獻

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